Evaluation of Cut Accuracy and Cis Cortical Damage for Tibial Plateau Leveling Osteotomy Performed with and without Aid of a Novel Saw Guide: An In Vitro Study

Abstract

To compare osteotomy orientation relative to the sagittal and transverse planes of the tibia, and cis cortical damage for tibial plateau leveling osteotomy (TPLO) performed with the following aids: (1) Synthes TPLO jig and saw guide, (2) Slocum TPLO jig with ancillary Kirschner wires (SlocumK), and (3) Slocum jig alone. In vitro study on Synbone(®) bone models and canine cadavers. Cadaveric pelvic limbs pairs (n = 30). TPLO was performed on 30 Synbone tibias with either the Slocum jig (n = 10), SlocumK (10), or Synthes jig (10). Synbones were analyzed to quantify osteotomy inclination, torsion, craniocaudal positioning, and medial cortical bone damage. Osteotomies were performed on cadaveric tibias and CT reconstruction used to assess the same osteotomy parameters. Significant differences in Synbone tibial osteotomy inclination (P<.001), medial cortical bone damage (P<.001) and craniocaudal osteotomy position (P<.05) were observed between the Synthes and Slocum jigs. CT analysis revealed significant differences in osteotomy inclination (P<.001) and torsion (P<.001). The use of the SlocumK resulted in osteotomies with minimal torsional malalignment however with high levels of metal debris and accelerated blunting of the TPLO blade. TPLO osteotomy inclination, torsion, and craniocaudal positioning are improved and the degree of iatrogenic medial cortical bone damage is minimal with the Synthes TPLO jig compared to the Slocum TPLO jig.